Carbon ion radiotherapy for patients with hepatocellular carcinoma in the caudate lobe

Abstract

Aim: The treatment of hepatocellular carcinoma in the caudate lobe (HCCCL) is technically challenging. We aimed to investigate the efficacy and toxicity of carbon ion radiotherapy (C-ion RT) for HCCCL. Methods: Patients with HCCCL treated with C-ion RT at our hospital between January 2011 and December 2018 were evaluated. The total dose was 52.8 or 60 Gy (relative biological effectiveness) in four or 12 fractions depending on the distance between the tumor and the gastrointestinal tract. The survival outcome, the presence or absence of recurrence (local recurrence, intrahepatic recurrence outside the irradiation field, or extrahepatic recurrence), and acute/late adverse events were evaluated. Results: Nine patients were included. The median tumor size was 3.4 cm, and the median follow-up duration was 18.3 months for all patients. No patient developed local recurrence during follow-up. Five patients subsequently developed intrahepatic recurrence outside the irradiation field and two had extrahepatic metastasis. Five patients died of hepatocellular carcinoma. No acute adverse events of grade ≥2 were observed. Two patients experienced grade 2 or 3 late adverse events, including obstructive jaundice, hepatic encephalopathy, ascites, and edema. Conclusion: Carbon ion radiotherapy for HCCCL achieved excellent local control with acceptable adverse events and can thus be a curative treatment option for HCCCL.

Carbon Ion Radiotherapy in the Treatment of Hepatocellular Carcinoma

“…CIRT has also been applied in situations where HCC is located in the caudate lobe. Okazaki et al [ 42 ] reported the results of CIRT in the treatment of HCC located in the caudate lobe. The study demonstrated no local recurrence, and only two instances of grade 2 or 3 late adverse events were observed among the nine patients.…”

Advances in the interventional therapy of hepatocellular carcinoma originating from the caudate lobe

“…Radiation therapy alone has been used in the treatment of caudate lobe HCC and has shown positive outcomes. 77 , 78 , 79 Other radiation therapy methods, such as stereotactic radiation therapy and selective internal radiation therapy (SIRT), have been used as additional options for local treatment. Brachytherapy can be used for the treatment of residual caudate lobe tumors that cannot be completely ablated.…”

Cost-Effectiveness Comparison of Carbon-Ion Radiation Therapy and Transarterial Chemoembolization for Hepatocellular Carcinoma

“… 11 , 12 , 13 , 14 Thus, CIRT can be safely applied to various patients with localized HCC. 15 , 16 , 17 , 18 , 19 A single-institution retrospective study using propensity score matching (PSM) demonstrated that CIRT resulted in better outcomes than TACE (3-year overall survival rate, 88% in the CIRT group vs 58% in the TACE group). 20 Therefore, CIRT may be a promising treatment option for patients with localized HCC who are ineligible for surgery or RFA.…”